Mitra H Bridwell, R, MR

Primary specialty

Magnetic Resonance Imaging Radiologic TechnologistTaxonomy code 2471M1202X

License

290989 Issued in AL

Practice address

1201 13TH Ave SE
Decatur, AL 35601-4300

Phone

(256) 350-7779

Fax

(256) 350-2272

NPI assigned

Jul 10, 2009

Last updated

Jul 10, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Open MRI of Decatur LLC

  dba Decatur Diagnostic Imaging

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Decatur, AL
  • NPI 1033179809
  NPD (past)
• Radiology of Hunstville PC

  • Diagnostic Radiology Physician
  • Huntsville, AL
  • NPI 1588621296
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247184000000",
    "number": "1023247145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MARYSA DR",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358118770",
            "telephone_number": "256-683-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 13TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014300",
            "telephone_number": "256-350-7779",
            "fax_number": "256-350-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDWELL",
        "first_name": "MITRA",
        "middle_name": "H",
        "credential": "R, MR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2009-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471M1202X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": "AL",
            "license": "290989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Tilford Braswell IV, M.D.
• Ashley Brenner
• Michelle Brewer, FNP-BC
• Brian R James MD PC
• Shequita Madry Bridgeforth, NP
• Yvonne Briggs, OTR/L
• Leah Bromley, RBT
• Kellie Kilpatrick Brooks, RBT
• Sarah Brooks
• Catherine Brown

• Magnetic Resonance Imaging Radiologic Technologist in Decatur, AL
• Providers in Decatur, AL by specialty
• Magnetic Resonance Imaging Radiologic Technologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.